Background: Although a number of studies have found an association between aircraft noise and hypertension, there is a lack of evidence on associations with other cardiovascular disease. For road traffic noise, more studies are available but the extent of possible confounding by air pollution has not been established. Methods: This study used data from the Hypertension and Environmental Noise near Airports (HYENA) study. Cross-sectional associations between self-reported ‘heart disease and stroke’ and aircraft noise and road traffic noise were examined using data collected between 2004 and 2006 on 4712 participants (276 cases), who lived near airports in six European countries (UK, Germany, Netherlands, Sweden, Greece, Italy). Data were available to assess potential confounding by NO₂ air pollution in a subsample of three countries (UK, Netherlands, Sweden). Results: An association between night-time average aircraft noise and ‘heart disease and stroke’ was found after adjustment for socio-demographic confounders for participants who had lived in the same place for ≥ 20 years (odds ratio (OR): 1.25 (95% confidence interval (CI) 1.03, 1.51) per 10 dB (A)); this association was robust to adjustment for exposure to air pollution in the subsample. 24 hour average road traffic noise exposure was associated with ‘heart disease and stroke’ (OR: 1.19 (95% CI 1.00, 1.41), but adjustment for air pollution in the subsample suggested this may have been due to confounding by air pollution. Statistical assessment (correlations and variance inflation factor) suggested only modest collinearity between noise and NO₂ exposures. Conclusions: Exposure to aircraft noise over many years may increase risks of heart disease and stroke, although more studies are needed to establish how much the risks associated with road traffic noise may be explained by air pollution.

In this study we present the first comprehensive analysis of the spatio-temporal differences in excess mortality during the COVID-19 pandemic in Italy. We used a population-based design on all-cause mortality data, for the 7,904 Italian municipalities. We estimated sex-specific weekly mortality rates for each municipality, based on the first four months of 2016–2019, while adjusting for age, localised temporal trends and the effect of temperature. Then, we predicted all-cause weekly deaths and mortality rates at municipality level for the same period in 2020, based on the modelled spatio-temporal trends. Lombardia showed higher mortality rates than expected from the end of February, with 23,946 (23,013 to 24,786) total excess deaths. North-West and North-East regions showed one week lag, with higher mortality from the beginning of March and 6,942 (6,142 to 7,667) and 8,033 (7,061 to 9,044) total excess deaths respectively. We observed marked geographical differences also at municipality level. For males, the city of Bergamo (Lombardia) showed the largest percent excess, 88.9% (81.9% to 95.2%), at the peak of the pandemic. An excess of 84.2% (73.8% to 93.4%) was also estimated at the same time for males in the city of Pesaro (Central Italy), in stark contrast with the rest of the region, which does not show evidence of excess deaths. We provided a fully probabilistic analysis of excess mortality during the COVID-19 pandemic at sub-national level, suggesting a differential direct and indirect effect in space and time. Our model can be used to help policy-makers target measures locally to contain the burden on the health-care system as well as reducing social and economic consequences. Additionally, this framework can be used for real-time mortality surveillance, continuous monitoring of local temporal trends and to flag where and when mortality rates deviate from the expected range, which might suggest a second wave of the pandemic.

Paris and London are Europe's two megacities and both experience poor air quality with systemic breaches of the NO2 limit value. Policy initiatives have been taken to address this: some European-wide (e.g. Euro emission standards); others local (e.g. Low Emission Zone, LEZ). Trends in NOX, NO2 and particulate matter (PM10, PM2.5) for 2005-2016 in background and roadside locations; and trends in traffic increments were calculated in both cities to address their impact. Trends in traffic counts and the distribution in Euro standards for diesel vehicles were also evaluated. Linear-mixed effect models were built to determine the main determinants of traffic concentrations. There was an overall increase in roadside NO2 in 2005-2009 in both cities followed by a decrease of ∼5% year-1 from 2010. Downward trends were associated with the introduction of Euro V heavy vehicles. Despite NO2 decreasing, at current rates, roads will need 20 (Paris) and 193 years (London) to achieve the European Limit Value (40 μg m-3 annual mean). Euro 5 light diesel vehicles were associated with the decrease in roadside PM10. An increase in motorcycles in London since 2010 contributed to the lack of significant trend in PM2.5 roadside increment in 2010-16.

Rationale: Exposure to air pollution during intrauterine development and through childhood may have lasting effects on respiratory health. Objectives: To investigate lung function at ages 8 and 15 years in relation to air pollution exposures during pregnancy, infancy, and childhood in a UK population–based birth cohort. Methods: Individual exposures to source-specific particulate matter ≤10 μm in aerodynamic diameter (PM10) during each trimester, 0–6 months, 7–12 months (1990–1993), and up to age 15 years (1991–2008) were examined in relation to FEV1% predicted and FVC% predicted at ages 8 (n = 5,276) and 15 (n = 3,446) years using linear regression models adjusted for potential confounders. A profile regression model was used to identify sensitive time periods. Measurements and Main Results: We did not find clear evidence of a sensitive exposure period for PM10 from road traffic. At age 8 years, 1 μg/m3 higher exposure during the first trimester was associated with lower FEV1% predicted (−0.826; 95% confidence interval [CI], −1.357 to −0.296) and FVC% predicted (−0.817; 95% CI, −1.357 to −0.276), but similar associations were seen for exposures for other trimesters, 0–6 months, 7–12 months, and 0–7 years. Associations were stronger among boys, as well as children whose mother had a lower education level or smoked during pregnancy. For PM10 from all sources, the third trimester was associated with lower FVC% predicted (−1.312; 95% CI, −2.100 to −0.525). At age 15 years, no adverse associations with lung function were seen. Conclusions: Exposure to road-traffic PM10 during pregnancy may result in small but significant reductions in lung function at age 8 years.